NUR 2755 Multidimensional Care IV (MDC 4) Final Exam
150 Practice Questions with Verified Answers and Detailed
Rationales | 2026-2027 | Graded A+
SECTION 1: PRIORITIZATION, DELEGATION, AND CLINICAL JUDGMENT
Questions 1-20
Q1. A nurse is caring for four patients. Which patient should the nurse assess
first?
A) A patient with COPD reporting a change in sputum color
B) A patient post-operative day 2 with pain rating 6/10
C) A patient with new-onset confusion and oxygen saturation of 88%
D) A patient requesting assistance to the bathroom
Answer: C) A patient with new-onset confusion and oxygen saturation of 88%
Rationale: New-onset confusion with hypoxemia (SpO2 88%) indicates acute
deterioration and requires immediate assessment. This patient is unstable and
should be seen first using Maslow's hierarchy and the ABCs (Airway, Breathing,
Circulation). Changes in mental status can indicate inadequate cerebral
oxygenation, which is a priority concern .
Q2. The nurse is using the ABCDE framework to prioritize care. Which condition
requires the most immediate intervention?
A) Decreased level of consciousness (Airway/Breathing)
B) Open wound (Disability)
C) Lack of IV access (Circulation)
D) Patient anxiety (Emotional)
Answer: A) Decreased level of consciousness (Airway/Breathing)
,Rationale: The ABCDE framework prioritizes Airway (patency), Breathing
(ventilation/oxygenation), Circulation (perfusion), Disability (neurologic status),
and Exposure. Decreased LOC affects airway protection and breathing, making it
the highest priority .
Q3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate for the nurse to delegate?
A) Administering oral medications
B) Assessing a patient's lung sounds
C) Obtaining a blood pressure on a stable patient
D) Developing the plan of care
Answer: C) Obtaining a blood pressure on a stable patient
Rationale: Delegation follows the five rights: right task, right circumstances, right
person, right direction, right supervision. Obtaining vital signs on a stable patient
is within UAP scope. Assessment, medication administration, and care planning
are the RN's responsibility .
Q4. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate for the RN to delegate?
A) Administering IV push morphine
B) Performing an initial admission assessment
C) Administering oral medications to stable patients
D) Patient teaching about discharge medications
Answer: C) Administering oral medications to stable patients
Rationale: LPNs can administer oral, IM, and subcutaneous medications to stable
patients in many states. IV push medications, initial assessments, and discharge
teaching require RN-level education and scope .
Q5. A nurse is preparing to give change-of-shift report. Which communication
tool is most effective for ensuring safe handoff?
,A) SBAR (Situation, Background, Assessment, Recommendation)
B) Verbal report without written documentation
C) Text message to the oncoming nurse
D) Email sent after the shift ends
Answer: A) SBAR (Situation, Background, Assessment, Recommendation)
Rationale: SBAR is a standardized communication tool that improves patient
safety during handoffs by providing a structured format for conveying critical
information. Verbal report alone or informal methods increase the risk of errors .
Q6. A patient who is 12 hours post-MI reports severe chest pain unrelieved by
nitroglycerin. The nurse should suspect:
A) Pericarditis (post-MI pericarditis, usually days to weeks later)
B) Extension of the MI (reinfarction)
C) Musculoskeletal pain
D) Anxiety
Answer: B) Extension of the MI (reinfarction)
Rationale: Chest pain unrelieved by nitroglycerin after an MI may indicate
reinfarction or extension of the MI. The nurse should obtain an ECG and notify the
provider immediately .
Q7. A nurse is caring for a patient who refuses a prescribed medication. What is
the nurse's best action?
A) Administer the medication anyway because it is ordered
B) Explain the risks of refusing the medication and document the refusal
C) Notify security to hold the patient down
D) Hide the medication in the patient's food
Answer: B) Explain the risks of refusing the medication and document the
refusal
, Rationale: Patients have the right to refuse treatment. The nurse should explain
the risks, respect the refusal, and document the refusal and any teaching
provided .
Q8. A nurse is caring for a patient who does not speak English. What is the best
way to communicate with the patient?
A) Use a family member as an interpreter
B) Use a certified medical interpreter (in-person or telephone)
C) Use hand gestures to communicate
D) Have the patient sign the discharge instructions without explanation
Answer: B) Use a certified medical interpreter (in-person or telephone)
Rationale: Certified medical interpreters ensure accurate communication. Family
members should not be used due to potential bias, lack of medical terminology,
and confidentiality concerns .
Q9. A nurse is preparing a patient for surgery. The patient signs the informed
consent form. Which statement indicates that the patient has understood the
teaching?
A) "I can't change my mind after signing."
B) "The surgeon explained the procedure, risks, and benefits."
C) "My nurse will be performing the surgery."
D) "I don't need to know the risks."
Answer: B) "The surgeon explained the procedure, risks, and benefits."
Rationale: Informed consent requires that the provider (surgeon) explains the
procedure, risks, benefits, and alternatives. The nurse witnesses the signature and
ensures the patient understands but does not provide the explanation .
Q10. A nurse is assigned to care for four patients. Which patient should the
nurse see first?
150 Practice Questions with Verified Answers and Detailed
Rationales | 2026-2027 | Graded A+
SECTION 1: PRIORITIZATION, DELEGATION, AND CLINICAL JUDGMENT
Questions 1-20
Q1. A nurse is caring for four patients. Which patient should the nurse assess
first?
A) A patient with COPD reporting a change in sputum color
B) A patient post-operative day 2 with pain rating 6/10
C) A patient with new-onset confusion and oxygen saturation of 88%
D) A patient requesting assistance to the bathroom
Answer: C) A patient with new-onset confusion and oxygen saturation of 88%
Rationale: New-onset confusion with hypoxemia (SpO2 88%) indicates acute
deterioration and requires immediate assessment. This patient is unstable and
should be seen first using Maslow's hierarchy and the ABCs (Airway, Breathing,
Circulation). Changes in mental status can indicate inadequate cerebral
oxygenation, which is a priority concern .
Q2. The nurse is using the ABCDE framework to prioritize care. Which condition
requires the most immediate intervention?
A) Decreased level of consciousness (Airway/Breathing)
B) Open wound (Disability)
C) Lack of IV access (Circulation)
D) Patient anxiety (Emotional)
Answer: A) Decreased level of consciousness (Airway/Breathing)
,Rationale: The ABCDE framework prioritizes Airway (patency), Breathing
(ventilation/oxygenation), Circulation (perfusion), Disability (neurologic status),
and Exposure. Decreased LOC affects airway protection and breathing, making it
the highest priority .
Q3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate for the nurse to delegate?
A) Administering oral medications
B) Assessing a patient's lung sounds
C) Obtaining a blood pressure on a stable patient
D) Developing the plan of care
Answer: C) Obtaining a blood pressure on a stable patient
Rationale: Delegation follows the five rights: right task, right circumstances, right
person, right direction, right supervision. Obtaining vital signs on a stable patient
is within UAP scope. Assessment, medication administration, and care planning
are the RN's responsibility .
Q4. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate for the RN to delegate?
A) Administering IV push morphine
B) Performing an initial admission assessment
C) Administering oral medications to stable patients
D) Patient teaching about discharge medications
Answer: C) Administering oral medications to stable patients
Rationale: LPNs can administer oral, IM, and subcutaneous medications to stable
patients in many states. IV push medications, initial assessments, and discharge
teaching require RN-level education and scope .
Q5. A nurse is preparing to give change-of-shift report. Which communication
tool is most effective for ensuring safe handoff?
,A) SBAR (Situation, Background, Assessment, Recommendation)
B) Verbal report without written documentation
C) Text message to the oncoming nurse
D) Email sent after the shift ends
Answer: A) SBAR (Situation, Background, Assessment, Recommendation)
Rationale: SBAR is a standardized communication tool that improves patient
safety during handoffs by providing a structured format for conveying critical
information. Verbal report alone or informal methods increase the risk of errors .
Q6. A patient who is 12 hours post-MI reports severe chest pain unrelieved by
nitroglycerin. The nurse should suspect:
A) Pericarditis (post-MI pericarditis, usually days to weeks later)
B) Extension of the MI (reinfarction)
C) Musculoskeletal pain
D) Anxiety
Answer: B) Extension of the MI (reinfarction)
Rationale: Chest pain unrelieved by nitroglycerin after an MI may indicate
reinfarction or extension of the MI. The nurse should obtain an ECG and notify the
provider immediately .
Q7. A nurse is caring for a patient who refuses a prescribed medication. What is
the nurse's best action?
A) Administer the medication anyway because it is ordered
B) Explain the risks of refusing the medication and document the refusal
C) Notify security to hold the patient down
D) Hide the medication in the patient's food
Answer: B) Explain the risks of refusing the medication and document the
refusal
, Rationale: Patients have the right to refuse treatment. The nurse should explain
the risks, respect the refusal, and document the refusal and any teaching
provided .
Q8. A nurse is caring for a patient who does not speak English. What is the best
way to communicate with the patient?
A) Use a family member as an interpreter
B) Use a certified medical interpreter (in-person or telephone)
C) Use hand gestures to communicate
D) Have the patient sign the discharge instructions without explanation
Answer: B) Use a certified medical interpreter (in-person or telephone)
Rationale: Certified medical interpreters ensure accurate communication. Family
members should not be used due to potential bias, lack of medical terminology,
and confidentiality concerns .
Q9. A nurse is preparing a patient for surgery. The patient signs the informed
consent form. Which statement indicates that the patient has understood the
teaching?
A) "I can't change my mind after signing."
B) "The surgeon explained the procedure, risks, and benefits."
C) "My nurse will be performing the surgery."
D) "I don't need to know the risks."
Answer: B) "The surgeon explained the procedure, risks, and benefits."
Rationale: Informed consent requires that the provider (surgeon) explains the
procedure, risks, benefits, and alternatives. The nurse witnesses the signature and
ensures the patient understands but does not provide the explanation .
Q10. A nurse is assigned to care for four patients. Which patient should the
nurse see first?
